Community Health and Preventive Medicine Commons^™

Discharged Against Medical Advice In The Postpartum Period: Why Should We Care?, Gurbani Bedi Bs, Mariam Ayyash Md, Mscr, Monique Swain Md

Medical Student Research Symposium

Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.

Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.

Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm births. 35.1% delivered via cesarean …

Recruitment, Retention, And Future Direction For A Heart Health Education And Risk Reduction Intervention Led By Community Health Workers In An African American Majority City, Julie Gleason-Comstock, Cindy Bolden Calhoun, Ghadir Mozeb, Cardell Louis, Alex B. Hill, Barbara J. Locke, Victor Harrell, Sadia Yasmin, Liying Zhang, John M. Flack, Nancy T. Artinian, Jinping Xu

Urban Studies and Planning Faculty Research Publications

Heart disease is a leading cause of death for African Americans. A community-academic partnership cross-trained community health workers to engage African American adults in a 6-month heart health education and risk reduction intervention. We conducted a one-group feasibility study using a one group (pre-posttest) design. A total of 100 adults were recruited from 27 zip codes in an African American majority city through community-based organizations (46%), churches (36%), and home visits (12%). Ninety-six percent were African American; 55% were female, 39% were male, and 6% were transgender. Their mean age was 44.6 years (SD=15.9). Ninety-two percent had health insurance. Seventy-six …

Assessing The Influence Of Food Insecurity And Retail Environments As A Proxy For Structural Racism On The Covid-19 Pandemic In An Urban Setting, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Kathrybn A. G Knoff, Hadis Dastgerdizad, Noel Kulik, James Mallare, Kibibi Blount-Dorn, Winona Bynum

Urban Studies and Planning Faculty Research Publications

A collaborative partnership launched the Great Grocer Project (GGP) in March 2021 in Detroit, Michigan where health inequities, including deaths due to COVID-19, have historically been politically determined and informed by socially entrenched norms. Institutional and structural racism has contributed to a lack of diversity in store ownership among Detroit grocers and limited access to high-quality, affordable healthy foods as well as disparate food insecurity among Detroit residents. The GGP seeks to promote Detroit’s healthy grocers to improve community health and economic vitality through research, programs, and policies that have the potential to advance health equity. A cross-sectional design was …

Infrastructure And Policies Supporting Physical Activity Habits: A Comparison Between The United States And Europe, Anisha Laddha

Honors College Theses

Most adults in the United States are not getting enough physical activity, and this is causing high rates of adverse health conditions such as diabetes and cardiovascular disease in the population. The rising costs of cardiovascular disease are a national problem that must be tackled from multiple perspectives. This literature review explores policies and infrastructure implemented in European countries with better health outcomes and higher physical activity levels in the population compared to the United States. The infrastructure in places such as Germany and Denmark is constructed to encourage physical activity in the form of active transportation such as walking …

From Pandemic Response To Portable Population Health: A Formative Evaluation Of The Detroit Mobile Health Unit Program, Phillip Levy, Erin Mcglynn, Alex B. Hill, Liying Zhang, Steven J. Korzeniewski, Bethany Foster, Jasmine Criswell, Caitlin O'Brien, Katee Dawood, Lauren Baird, Charles J. Shanley

Urban Studies and Planning Faculty Research Publications

This article describes our experience developing a novel mobile health unit (MHU) program in the Detroit, Michigan, metropolitan area. Our main objectives were to improve healthcare accessibility, quality and equity in our community during the novel coronavirus pandemic. While initially focused on SARS-CoV-2 testing, our program quickly evolved to include preventive health services. The MHU program began as a location-based SARS-CoV-2 testing strategy coordinated with local and state public health agencies. Community needs motivated further program expansion to include additional preventive healthcare and social services. MHU deployment was targeted to disease “hotspots” based on publicly available SARS-CoV-2 testing data and …

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

The Effect Of Nurse Case Coordination On Management Of Chronic Conditions, Aayush Mittal Ms-Hsm

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Ishani A, Greer N, Taylor BC, et al. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: a randomized controlled trial. Diabetes Care. 2011;34(8):1689-1694. https://doi.org/10.2337/dc10-2121

for a patient requiring care coordination for management of hypertension, diabetes, and hyperlipidemia.

The Biopsychosocial Model And Clinical Decision Science In The Age Of Black Lives Matter: A Clinical Reflection, Abdul-Rahman M. Suleiman, Samer Ilayan

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the biopsychosocial considerations of elevated blood pressure in teenage African American youth during the era of Black Lives Matter (BLM). Parallels are drawn between Dr. Engel’s biopsychosocial model and clinical decision science.

Substance Use Disorder Program Facilities In Detroit: A Geographic Analysis, Oksana Doubrovski

Medical Student Research Symposium

Background: Over 630,000 Michiganders have a substance use disorder (SUD) and about 80% are not receiving care (1). The rate of unmet need for SUD care in the Detroit-Dearborn-Livonia area is 81% (1). Geographic placement of facilities may serve as a barrier in patient access to SUD program services. This geographic analysis investigates current Detroit SUD program facility locations and their community demographics.

Methods: ArcGIS Pro was used to visualize and analyze data by creating 2D maps and tables. Data on SUD programs, medically underserved areas, and zip codes were retrieved from government data portals. Census tract data …

Violence As A Deterrent For Shelter Usage Among Persons Experiencing Homelessness In Detroit: A Mixed Methods Study, Trishya L. Srinivasan

Medical Student Research Symposium

Introduction: Persons experiencing homelessness (PEH) are hospitalized at rates four times higher than the US average and face significantly worse health outcomes, particularly for those residing in cities with harsh winters. Fear of violence or theft is frequently cited as a deterrent to emergency-based shelter usage among PEH; however, there is little research assessing its effects on health and safety among PEH. This project qualitatively assesses violence as a deterrent to emergency shelter usage.

Methods: A semi-structured interview guide was designed to assess experiences with, and fear of, shelter-based violence among PEH and the effect of shelter-based violence on mental …

Utility Of Student-Run Free Clinics For Underserved Individuals During Covid-19 Michigan Shelter-In-Place Order, Sara Saymuah, Hailey Heil, Janki Vaghasia, Marla Rojas Thaureaux, Victoria Badia, Paige Baal

Medical Student Research Symposium

Introduction: Cass Clinic, a student-run free clinic (SRFC) affiliated with Wayne State University School of Medicine in Detroit, Michigan, provides free healthcare to predominantly underprivileged populations. Cass Clinic remained open during Governor Whitmer’s shelter-in-place order from March 24, 2020 through June 12, 2020 and throughout the COVID-19 pandemic. The purpose of this study was to assess SRFC’s utility in meeting patient needs during the COVID-19 pandemic.

Methods: A mixed, open and closed-ended quality improvement survey was administered to patients who utilized Cass Clinic between the dates of May 2, 2020 and June 6, 2020. Qualitative analysis included descriptive statistics, while …

Impact Of Covid-19 On Service Utilization By Those Experiencing Homelessness In Detroit, Anneliese Petersen, Richard Bryce D.O.

Medical Student Research Symposium

Background:

Current research has demonstrated increased levels of fear and anxiety due to the Coronavirus pandemic. While fear can have a significant impact on any individual, fear among individuals experiencing homelessness is particularly impactful as this may affect service utilization and thus the ability of to access basic necessities such as food, shelter and water. This study seeks to understand the impact of fear of contracting COVID on service utilization among those experiencing homelessness in Detroit, MI.

Methods and Results:

From July-August 2020, 35 individuals who self-identified as homeless participated in a multiple-choice survey. 40% of surveyed individuals stated that …

Antibiotics And Antimicrobial Resistance In The Covid-19 Era: Perspective From Resource-Limited Settings, Mentor Ali Ber Lucien, Michael F. Canarie, Paul E. Kilgore, Gladzin Jean-Denis, Natael Fénélon, Manise Pierre, Mauricio Cerpa, Gerard A. Joseph, Gina Maki, Marcus J. Zervos, Patrick Dely, Jacques Boncy, Hatim Sati, Ana Del Rio, Pilar Ramon-Pardo

Department of Pharmacy Practice

The dissemination of COVID-19 around the globe has been followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. The identification of bacterial pathogens is challenging in low and middle income countries (LMIC), as there are no readily-available and cost-effective clinical or biological markers that can effectively discriminate between bacterial and viral infections. Fortunately, faced with the threat of COVID-19 spread, there has been a growing awareness of the importance of antimicrobial stewardship programs, as well as infection prevention and control measures that could help reduce the microbial load and hence …

Improved Tolerability And Efficaciousness Of Miralax-Gatorade When Compared To Golytely In The Outpatient Setting, Bassem Farah

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using Gu P, Lew D, Jung OS, et al. Comparing the Real-World Effectiveness of Competing Colonoscopy Preparations: Results of a Prospective Trial. Am J Gastroenterol. 2019;114(2):305-314. https://doi.org/10.14309/ajg.0000000000000057 for a patient reluctant to undergo colonoscopy screening due to concerns about GoLYTLEY's tolerability.

Michigan Food Insecurity, Food Access, And Food Worries During The Covid-19 Pandemic, Alyssa W. Beavers, Michelle M. Litton

Nutrition and Food Science Faculty Research Publications

No abstract provided.

Toxic Structures: Speculation And Lead Exposure In Detroit's Single-Family Rental Market, Alexa Eisenberg, Eric Seymour, Alex B. Hill, Joshua Akers

Urban Studies and Planning Faculty Research Publications

Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor-landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥ 5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale. These findings highlight the potential for property speculation in post-foreclosure housing markets to exacerbate severe and racialized burdens of excess lead toxicity …

The Population Health Outcomes And Information Exchange (Phoenix) Program - A Transformative Approach To Reduce The Burden Of Chronic Disease, Steven J. Korzeniewski, Carla Bezold, Jason T. Carbone, Shooshan Danagoulian, Bethany Foster, Dawn Misra, Maher M. El-Masri, Dongxiao Zhu, Robert Welch, Lauren Meloche, Alex B. Hill, Phillip Levy

Urban Studies and Planning Faculty Research Publications

This concept article introduces a transformative vision to reduce the population burden of chronic disease by focusing on data integration, analytics, implementation and community engagement. Known as PHOENIX (The Population Health OutcomEs aNd Information EXchange), the approach leverages a state level health information exchange and multiple other resources to facilitate the integration of clinical and social determinants of health data with a goal of achieving true population health monitoring and management. After reviewing historical context, we describe how multilevel and multimodal data can be used to facilitate core public health services, before discussing the controversies and challenges that lie ahead.

Improving Hearing Screenings With Tele-Otology, Ryan J. Miller, Joshua George-Lopez, Robert S. Hong Md, Phd

Medical Student Research Symposium

Introduction: The Lions Hearing Center of Michigan (LHC-MI) is an assistance program in Detroit that provides hearing aids to individuals in need. LHC-MI has provided thousands of hearing aids, but such efforts have been costly, requiring patients to make multiple appointments at multiple locations. To streamline this process, the LHC-MI is piloting a new program, titled “Hear Now! Detroit!”, that uses telemedicine to reach patients at community sites.

Purpose: To evaluate the feasibility of a hearing screening program that uses telemedicine to reduce the number of visits required to acquire hearing aids.

Methods: Teams of community volunteers were deployed to …

Outcomes Of Utilizing Uber Health To Improve Access To Healthcare At An Urban Student Run Free Clinic, Ciara Ivanics Ms, Emily Lau, Julie Fynke Mph, Ralph Williams Md, Juliann Binienda Phd

Medical Student Research Symposium

Introduction: The patient population of the Robert R. Frank Student Run Free Clinic (SRFC) often cite transportation as their most significant barrier to receiving care. Utilization of ridesharing services may reduce this barrier and improve patient adherence to clinic appointments.

Methods: All patients at the SRFC from February 2019 through November 2019 were offered participation in this IRB-approved randomized control trial (n=37). The intervention group was offered a roundtrip, free, pre-scheduled Uber Health ride, while the control group was offered free public transportation or utilized their own transportation. Participants received an appointment reminder by phone within two days of their …

First Aid First: Implementation And Evaluation Of A Community-Based First Aid Training Course, Luke Wesemann

Medical Student Research Symposium

In 2018, medical students at Wayne State University School of Medicine (WSUSOM) created a first aid training initiative called First Aid First (FAF). FAF is a comprehensive community-based training program that teaches lifesaving skills tailored for Detroit. The objective of this initiative was to improve the confidence and basic first aid skills of those who attend trainings.

Pre- and post-test surveys were used to measure knowledge, confidence and skill level. The survey data gathered from March 2018-October 2019 consisted of 5 Likert scale questions for self-evaluation component and 23-25 multiple choice questions, number depending on time of administration due to …

Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd

Medical Student Research Symposium

Introduction: Developments in technology, such as the popularity of mobile devices and social media outlets, have enhanced the ability of individuals to communicate. Currently, search engines allow for easy exploration of information related to every topic of interest. Our study purpose was to evaluate the impact of technological and social collaborations on sexual and reproductive health knowledge (SRHK).

Methods: A 50-item survey instrument, integrating factors of sociodemographics, number/type of social collaborations, technological communication use, and SRHK, was developed to assess familiarity with sexual and reproductive health perceptions. The survey was provided to consenting patients in an ambulatory, primary care setting. …

The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh

Medical Student Research Symposium

Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within …

The Modifiability Of Risk Factors Associated With Adolescent Suicide And Its Preventions, Nastaeen Tajin

Honors College Theses

Adolescent suicide has been of major concern in the past few decades, with the rates steadily increasing every year. Suicide can be defined as the act of intentionally taking one’s life. Adolescent refers to children between the age of 13 and 19, although the term will be used interchangeably with ‘teen’ throughout this paper. The purpose of this study had been to identify the risk factors of suicide associated with children of this age range, and propose preventative measures based on the modifiability of these risk factors. In order to achieve this, the two search catalogs utilized were the Wayne …

Detroit Health Department: Lead Report 2016, Abdul El-Sayed, Alex B. Hill, Haifa Haroon

Urban Studies and Planning Faculty Research Publications

The Epidemiology team at the Detroit Health Department rigorously stress- tested Detroit’s lead numbers. The findings suggest a true decline in EBLL levels rather than a decrease in lead testing or a change in the characteristics of the children who are being tested.

Socioeconomic Position And Incident Mobility Impairment In The Cardiovascular Health Study, Cheryl K. Nordstrom, Ana V. Diez Roux, Richard Schulz, Mary N. Haan, Sharon A. Jackson, Jennifer L. Balfour

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

We investigated if personal socioeconomic position (SEP) factors and neighborhood characteristics were associated with incident mobility impairment in the elderly.

Methods

We used data from the Cardiovascular Health Study, a longitudinal, population-based examination of coronary heart disease and stroke among persons aged 65 and older in the United States.

Results

Among 3,684 persons without baseline mobility impairment, lower baseline SEP was associated with increased risk of incident mobility disability during the 10-year follow-up period, although the strengths of these associations varied by socioeconomic indicator and race/sex group.

Conclusion

Among independent-living elderly, SEP affected development of mobility impairment into …